POS0963 PERINATAL DEATHS IN WOMEN WITH AUTOIMMUNE RHEUMATIC DISEASES
Authors: M. E. Corral Trujillo, R. A. Cerda González, H. G. Martínez Sandoval, A. Carrazco Chapa, F. R. Arevalo Nieto, C. M. Skinner Taylor, L. Pérez Barbosa, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The grief over the death of a baby around the date of birth registers becomes a traumatic event and generates emotional distress, changes in sleep and eating patterns, vulnerability to illness and an increased risk of maternal mortality up to two years following the loss [1]. In México during 2021, 23,000 fetal deaths were registered: 83.5% were before birth, 15.3% during birth and 1.2% was not specified [2]. Women with autoimmune rheumatic diseases (ARDs) have greater risk of perinatal loss, the correct psychological approach is fundamental in the grieving process when these events occur. <h3>Objectives</h3> Describe the frequency and characteristics of the perinatal loss (PL) in women with ARDs. <h3>Methods</h3> A descriptive, observational, cross-sectional study was conducted; we selected patients with history of PL from 2017 to date. Clinical records from the Pregnancy and Rheumatic Diseases Clinic (CEER) from the Hospital University "Dr. José Eleuterio González" in México were revised to obtained ARDs, obstetric clinical history, socioeconomic studies and the Edinburgh Postnatal Depression Scale (EPDS) scores. <h3>Results</h3> From the 79 patients that have been admitted to the clinic, 16 (20%) had PL. The ARDs more frequent was Rheumatoid Arthritis (RA) with 7 (43.8%) patients, Systemic Lupus Erythematosus (SLE) with 6 (37.5%) and other diagnosis (Dermatomyositis, Antiphospholipid Syndrome and UCTD) with 3 (18.9%), other characteristics are displayed in <b>table 1</b>. Twelve of these patients have their ARDs active during their pregnancy, 4 of them didn't continue with their rheumatic treatment after the event. Regarding the PL; 6 (37.5%) experienced the loss during the first trimester, 3 (18.7%) in the second trimester and 1 (6.2%) in the third trimester and 6 (37.5%) were neonatal losses. From all the pregnancies, 9 were not planned and 13 were desired. Grieving counseling was offered to the patients, only 5 (31.2%) get the counseling for an unspecified period of time. All the patients were asked to respond the EPDS; only 11 (69%) of them answered it and 3(27%) got a score greater than 13 (need for follow up of possible depressive symptoms). Of this deaths, one was in the second trimester and two were after birth. Scores greater than 13 were correlated with education, marital status, total number of PL and agreeing to the grieving counseling. No statistically significant correlation was found. <h3>Conclusion</h3> We have a 20% loss rate in our population. Women with ARDs that experienced one or more perinatal deaths could have greater risk to develop physical and emotional complications after the event. It's necessary to develop a proper guideline to treat our patients and prevent physical and emotional struggles. <h3>References</h3> [1]Song J, Mailick MR, Greenberg JS, Floyd FJ. Mortality in parents after the death of a child. Social Science &amp; Medicine. 2019 Oct;239:112522. [2]Comunicado de prensa núm. 486/22 31 de Agosto de 2022. Páginas 1/15 [Internet]. Org.mx. [citado el 11 de enero de 2023]. Disponible en: https://www.inegi.org.mx/contenidos/saladeprensa/boletines/2022/EDF/EDF2021.pdf <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.